Duty and the epidemic in Haiti

ON Friday, December 3, the UN decided to devote a session of the General Assembly to an analysis of the cholera epidemic in this neighboring country. The news of that decision was hopeful. Surely it would serve to alert international opinion to the gravity of the situation and mobilize support for the Haitian people. At the end of the day, its raison d’être is to confront problems and promote peace.

The current period in Haiti is grave, and the urgently required aid is little. Every year, our agitated world invests $1.5 trillion in arms and wars; Haiti – a country which less than one year ago suffered the brutal earthquake that resulted in 250,000 dead, 300,000 injured and enormous destruction – according to expert calculations, requires $20 billion for its reconstruction and ascending development, just 1.3% of what is spent in one year to those ends.

But now, it is not about that, which would constitute a simple dream. The UN is not only appealing for modest economic aid that could be resolved in a few minutes, but also for 350 doctors and 2,000 nurses, not possessed by the poor countries and whom the rich countries generally snatch from the poor ones. Cuba responded immediately, volunteering 300 doctors and nurses. Our Cuban Medical Mission in Haiti is treating close to 40% of those affected by cholera. In the wake of the call from that international organization, they rapidly took on the task of discovering the concrete causes of the high mortality rate. The low mortality rate of the patients whom they are treating is less than 1% – is reducing and will continue reducing every day – as compared to the 3% of persons treated in other health centers operating in the country.

It is evident that the number of deaths is not confined to the 1,800-plus people recorded. That figure does not include those who die without having gone to the existing doctors and heath centers.

Inquiring into the causes of those arriving in the most serious condition at the centers combating the epidemic and treated by our doctors, they observed that they came from the most distant sub-communes with the least communication. Haiti’s land surface is mountainous, and many isolated points can only be reached by moving over rugged ground.

The country is divided into 140 urban or rural communes, and 570 sub-communes. In one of the isolated sub-communes, where approximately 5,000 live – according to the Protestant pastor there – 20 people had died as a result of the epidemic without having attended a health center.

According to urgent investigations on the part of the Cuban Medical Mission in coordination with the national health authorities, it has been confirmed that 207 Haitian sub-communes in the most remote areas lack access to the centers fighting cholera or providing medical attention.

The abovementioned United Nations meeting ratified the need highlighted by Ms. Valerie Amos, UN Under-secretary General for Humanitarian Affairs and Emergency Relief, who made an urgent two-day visit to the country and calculated the figure of 350 doctors and 2,000 nurses. It was necessary to know the human resources existing in the country in order to calculate the number of personnel needed. That factor also depends on the hours and days devoted by the personnel fighting against the epidemic. One important fact to bear in mind is not only the time that they devote to their work, but the hour. The analysis of the high mortality rate reveals that 40% of deaths take place in nighttime hours, which points to affected patients not receiving the same attention to their disease during those hours.

Our mission estimates that the optimum use of personnel would reduce the abovementioned total. By mobilizing the available human resources of the Henry Reeve Brigade and the ELAM graduates that it has, the Cuban Medical Mission is convinced – even in the midst of the tremendous adversities originating from the earthquake destruction, the hurricane, unforeseeable heavy rainfall and the poverty – that the epidemic can be dominated and the lives of thousands of people who will inexorably die in the current circumstances, can be saved.

Sunday 28th was the date of elections for the presidency, the totality of the Chamber of Representatives and part of the Senate, a tense and complex event that seriously concerned us, given that it is related to the epidemic and the traumatic situation in the country.

In his statement on December 3, the UN secretary general stated textually: “Whatever the complaints or reservations about the process, I urge all political actors to refrain from violence and to start discussions immediately to find a Haitian solution to these problems – before a serious crisis develops,” an important European news agency reported.

According to the same news agency, the secretary general appealed to the international community to complete the handover of $164 million, of which only 20% has been forthcoming.

It is not right to direct oneself to a country like someone who is scolding a little child. Haiti is a country that, two centuries ago, was the first in this hemisphere to end slavery. It has been the victim of all kinds of colonial and imperialist aggressions. It was occupied by the government of the United States barely six years ago after the latter promoted a fratricidal war. The existence there of a foreign occupation force, in the name of the United Nations, does not deprive that country of the right to respect for its dignity and its history.

We consider the position of the UN secretary general in appealing to Haitian citizens to avoid confrontations among themselves as correct. On November 28, at a relatively early hour, the opposition parties endorsed a call for street protests, thus provoking demonstrations and creating notable confusion within the country, particularly in Port-au-Prince; but, above all, outside of the country. Nevertheless, both the government and the opposition managed to avoid acts of violence. The following day the nation was calm.

The European agency stated that Ban Ki-moon had stated in relation to “last Sunday’s elections in Haiti […] that the ‘irregularities’ registered ‘now seem more serious than initially thought.’

Anyone who has read all the news coming in from Haiti and the latest statements of the main opposition candidates would find it impossible to understand that the person appealing for averting fratricidal fighting in the wake of the confusion created among voters in the run-up to the results of the count which will determine the two rival candidates in the January elections, is now saying that the problems were more serious than he initially thought, which is tantamount to fuelling the flames of political antagonisms.

Yesterday, December 4, was the 12th anniversary of the arrival of the Cuban Medical Mission in the Republic of Haiti. Since them, thousands of Cuban public health doctors and technical personnel have been providing services in Haiti. We have experienced with its people times of peace, or of war, earthquakes, hurricanes and cyclones. We will be with them in these times of intervention, occupation and epidemics.

The president of Haiti, the central and local authorities, whatever their religious or political ideas, know that they can count on Cuba. Fidel Castro Ruz December 5, 2010 8:12 p.m.